A Bi-Objective Integrated Reverse Supply Chain Design for Durable Products

Over the past few years, manufacturers in several countries are faced with legislations on the take-back of their End-Of-Life (EOL) products. Meanwhile, many companies are recognizing the product recovery as an opportunity for saving production costs and accessing new markets. Reverse supply chains (RSCs) process used products returns so as to recover value by re-processing them and redistributing them in the market. This thesis proposes a RSC design model that simultaneously considers forward and reverse flows in the context of durable products. Such products consist of different modules, parts, and materials that can be recovered through several disposition options. Since RSCs deal with multiple quality states of used items, we assume that the returned items fit into two quality categories that differ in the quantities of recoverable components, as well as their available quantity and price. Unlike the majority of contributions in the literature, we focus on all types of recovery options in the network design model. Moreover, rather than considering a single profit maximization objective function, we also consider another objective for maximizing environmental benefits. We formulate this problem as a mixed integer linear programming (MILP) model. We apply the proposed model to an academic case study in the context of EOL washing machines. The bi-objective RSC design model is solved by the aid of the ɛ-constraint method. Finally, in order to identify the significant factors affecting each objective function, a set of sensitivity analysis tests is conducted. Managerial implications are also provided based on the results of the sensitivity analysis and the ɛ-constraint method

Cross-Country Study of Institutionalizing Social Participation in Health Policymaking: A Realist Analysis

Strong evidence suggests that interventions based on community participation have a positive effect on a range of health outcomes in different settings. Community participation contributes significantly to the promotion of health at the local level, especially among the more disadvantaged groups of the society. The main goal of social participation mechanisms is to fill the gap between the views of the policymakers and the experiences and needs of the communities. An important point is that institutionalization of social participation in the development of health policies and its continuity over time are essential requirements. The question here is how participation should be institutionalized in the systems that have started this process. We conducted a realistic evaluation of a multicase study of public participation in health system policymaking. Countries including France, Chile, Iran, Thailand, and Tunisia were selected. The study objective was to determine interventions and mechanisms used by these countries for community participation in health policymaking and institutionalizing it. The data were extracted via a literature review for each country using a realistic approach analysis also known as context, intervention, mechanism, and outcome (CIMO) configurations. Thailand and France, which have applied a set of interventions such as supportive legislations, evidence production structures for informed decision making and interactions, accountability and transparency, and providing a context for development of civil society organizations, have succeeded in institutionalizing community participation in health policymaking. Iran, Tunisia, and Chile have been successful in this regard, but they are still far from institutionalizing community participation. Success in the institutionalization of participatory health governance requires a political will and commitment at the highest level in order to minimize the conflicts between economic and political interests of different stakeholders and to implement a set of interventions to maximize social participation in health policymaking

Sustainable political commitment is necessary for institutionalizing community participation in health policy-making: Insights from Iran.

Background: Community participation is currently utilized as a national strategy to promote public health and mitigate health inequalities across the world. While community participation is acknowledged as a civic right in the Constitution of Iran and other related upstream documents, the government has typically failed in translating, integrating and implementing community participation in health system policy. The present study was conducted to determine the level of public voice consideration within the health policy in Iran and address fundamental interventions required to promote the public voice in the context of Islamic Republic of Iran (IRI). This study has originality because there is no study that addresses the requirements of institutionalizing community participation especially in low-middle-income countries, so Iran’s experience can be useful for other countries. Methods: Methodologically, this study utilized a multi-method and multi-strand sequential research design, including qualitative, comparative and documentary studies. In the first phase, the current level of community participation in the health policy cycle of Iran was identified using the International Association for Public Participation (IAP2) spectrum. In the second phase, a comparative study was designed to identify relevant interventions to promote the community participation level in the selected countries under study. In the third phase, a qualitative study was conducted to address the barriers, facilitators and strategies for improving the level of public participation. Accordingly, appropriate interventions and policy options were recommended. Interventions were reviewed in a policy dialogue with policy-makers and community representatives, and their effectiveness, applicability and practical feasibility were evaluated. Results: Based on the IAP2 spectrum, the level of community participation in the health policy-making process is non-participation, while empowerment is set at the highest level in the upstream documents. Moreover, capacity-building, demand, mobilization of the local population, provision of resources and setting a specific structure were found to be among the key interventions to improve the level of community participation in Iran’s health sector. More importantly, “political will for action” was identified as the driving force for implementing the necessary health interventions. Conclusions: To sum up, a paradigm shift in the governing social, economic and political philosophy; establishing a real-world and moral dialogue and communication between the government and the society; identifying and managing the conflicts of interest in the leading stockholders of the healthcare system; and, more importantly, maintaining a stable political will for action are integral to promote and institutionalize participatory governance in the health sector of Iran. All of the above will lead us to scheme, implement and institutionalize suitable interventions for participatory governance in health and medicine

Dropouts and Social Determinants of Health; Policy for the Prevention of School Dropout, Qualitative Study of the Causes and Interventions

Background: Indicators of the level of education are the most important parameters influencing each country′s development. Social indicators considered to be a determinant of one′s health consists of two constituents namely; (1) Rate of students enrolled in elementary, guidance, secondary and higher education and (2) the rate of adult literacy. This study is aimed to evaluate the situation of school dropouts in Iran, their causes, and appropriate interventions. Methods: Data were collected through literature review (including published researches and analysis of documents), focus group discussions with the presence of experts from (Department of Community Health, Academy of Medical Sciences) and interviews with stakeholders then these data were classified and presented in three sections namely; current situation, causes and solutions. Results: Results showed that Iran′s current situation in terms of school dropouts is unsatisfactory in comparison to developed countries and in some countries in the region. Influencing factors for school dropouts were classified into (1) Individual factors such as intellectual disability and behavioral disorders (2) group factors such as peer groups, family problems and children′s reduced interests in school and (3) major factors such as educational system and the changes of value, economic, cultural, and political issues. Conclusions: The present study, with the presentation of statistical documents specifically of the current problem of school dropouts in all levels of the Iranian society has been determined and aside from identifying the causes and factors affecting school dropouts, provision of strategies in three levels of prevention to combat this problem has been addressed